Bipolar Disorder and ADHD: Comorbidity and Diagnostic Distinctions

Marangoni, Ciro; Chiara, Lavinia De; Faedda, Gianni L.

doi:10.1007/s11920-015-0604-y

Cited by 67 publications

(52 citation statements)

References 76 publications

(93 reference statements)

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“…However, at least for the comparison of mortality between males and females, it is unlikely that residual confounding persisted, since the sibling analysis generated a similar adjusted HR (1.46, 95% CI 1.35 to 1.58) as the non-sibling analysis (1.44, 95% CI 95% CI 1.37 to 1.51). Nevertheless, this study did not detail important factors in child development, including mental illness (eg, attention deficit hyperactivity disorder (ADHD) or bipolar disorder25 and educational attainment, nor were parental marital status or parental-child engagement assessed.…”

Section: Discussionmentioning

confidence: 99%

Mortality in a cohort of 3.1 million children, adolescents and young adults

Ray

Guttmann

Silveira

et al. 2020

J Epidemiol Community Health

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BackgroundMany youth deaths occur in the first year of life, from prematurity and anomalies. Detailing mortality after age 1 year may differentially guide preventive strategies in children, adolescents and young adults.MethodsA cohort study in Ontario, Canada comprised 3 139 698 children born from 1990 to 2016. Adjusted HR (aHR) for death between 1 and 24 years were generated, comparing demographic variables and parity.ResultsAfter a median of 13.7 years of follow-up, 6930 deaths occurred between ages 1 and 24 years (incidence rate 17.0 per 100 000 person-years), peaking at age 23 years (43.7 per 100 000). The aHR for death was higher among males than females (1.44, 95% CI 1.37 to 1.51), rural versus urban areas (1.48, 95% CI 1.39 to 1.58), lowest versus highest income areas (1.39, 95% CI 1.29 to 1.51) and at parity 1 (1.16, 95% CI 1.10 to 1.23), parity 2 (1.34, 95% CI 1.23 to 1.45), parity 3+ (1.96, 95% CI 1.74 to 2.21), each relative to a child without an older sibling. Among males, the proportion of deaths due to injury jumped from 30% before age 15 years to 65% thereafter, and in females, from 28% to 51%. Intentional self-harm/assault explained 11% of injury-related deaths among males before age 15 years, and 20% thereafter, with respective figures of 18% and 17% for females. Deaths outside of hospital increased with age, from 35% at age 1 year, to 66% at age 22 years.ConclusionThere is a heightened susceptibility of dying starting at age 15 years, especially among males, from injury, and arising outside of hospital.

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Section: Discussionmentioning

confidence: 99%

Mortality in a cohort of 3.1 million children, adolescents and young adults

Ray

Guttmann

Silveira

et al. 2020

J Epidemiol Community Health

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“…Differentiating ADHD and bipolar disorder is complicated by similarities between the disorders including early age of onset, reciprocal comorbidity, similar psychiatric comorbidities, chronic course and persistence into adulthood; both disorders are also associated with impaired educational, occupational and interpersonal functioning, and increased morbidity and mortality in adulthood 94 . Clinical differentiation is most challenging when ADHD is comorbid with conduct disorder and/or oppositional defiant disorder, since the presenting symptoms (e.g.…”

Section: Attention Deficit Hyperactivity Disordermentioning

confidence: 99%

“…temper tantrum, aggressive behavior) can overlap with symptoms of a manic or mixed state. In uncomplicated cases, the appearance of prominent mood dysregulation, sleep irregularities and aggressive behaviors are more likely to predict a diagnosis of bipolar disorder than ADHD, especially if there is impulsive behavior associated with spending money, sex, or tobacco, alcohol or drug use 94 . Conversely, fidgeting, restlessness, and inefficient and disorganized behaviors arising from inattentiveness, distractibility and forgetfulness, often suggest ADHD.…”

Section: Attention Deficit Hyperactivity Disordermentioning

confidence: 99%

Bipolar depression: the clinical characteristics and unmet needs of a complex disorder

McIntyre

Calabrese

2019

Current Medical Research and Opinion

105

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Objective: We reviewed important clinical aspects of bipolar depression, a progressive psychiatric condition that is commonly treated in primary care. Bipolar depression is associated with considerable burden of illness, high suicide risk, and greater morbidity and mortality than bipolar mania. Methods: We identified articles relevant to our narrative review using a multistep search of the literature and applying terms that were relevant to bipolar depression or bipolar disorder. Results: Bipolar depression accounts for the majority of time spent unwell for patients with bipolar disorder; high rates of morbidity and mortality arise from full symptomatic episodes and interepisode subsyndromal symptoms. Bipolar depression is an important contributor to long-term dysfunction for patients with bipolar disorder due to psychosocial impairment, loss of work productivity and high rates of substance abuse. Missed and delayed diagnosis is prevalent due to overlapping symptoms with unipolar depression and other diagnoses. Medical comorbidities (i.e. cardiovascular disease, hypertension, obesity, metabolic syndrome) and psychiatric comorbidities (i.e. anxiety disorder, personality disorder, eating disorder, attention-deficit/hyperactivity disorder) are common. Currently, only three treatments are FDA-approved for bipolar depression; monotherapy antidepressants are not a recommended treatment option. Conclusions: Bipolar disorder is common among primary care patients presenting with depression; it is often treated exclusively in primary care. Clinicians should be alert for symptoms of bipolar disorder in undiagnosed patients, know what symptoms probabilistically suggest bipolar versus unipolar depression, have expertise in providing ongoing treatment to diagnosed patients, and be knowledgeable about managing common medication-related side effects and comorbidities. Prompt and accurate diagnosis is critical. ARTICLE HISTORY

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“…Step 2: Identifying desired information and choosing adequate screening questionnaires The validated screening questionnaires were chosen in collaboration with national key opinion leaders and with regard to frequent comorbid states in child and adolescent psychiatry [17][18][19]. The following eleven questionnaires were chosen.…”

Section: Resultsmentioning

confidence: 99%

Issues in Child and Adolescent Inpatient Assessment and Evaluation After Discharge: Protocol for App Development and a Randomized Controlled Trial (Preprint)

Hansson¹,

Johansson²,

Andersson³

et al. 2018

Preprint

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Background: New methods for in-and outpatient data collection and for improvning outpatient compliance after discharge are called for. Interactive and mobile technologies i.e. smartphone applications (apps) have shown promising results, e.g. helping unwell people by offering support and resources. Screening the current condition, including comorbidity, is a vital part of psychiatric care. Comorbid conditions, especially in emergency evaluation, are often missed leading to inaccurate diagnosis and treatment. Also in child and adolescent psychiatric emergency settings, little is known regarding treatment satisfaction. One way of improving diagnostic accuracy and to increase knowledge regarding treatment satisfaction is to use a structured diagnostic process as well as adding a tool to assess consumer satisfaction. Digitalized screening and follow-up has the advantage of making the administration and scoring easier and less time consuming leading to higher response rate. To address the described problems we decided to create a smartphone application: Blå Appen. Objective: The aim of this paper is to describe the development of Blå Appen and to describe the two planned research studies to evaluate the application. Methods: Blå Appen was developed through 7 different steps: (1) Identifying the need for quick and easy information gathering; (2) identifying desired information and choosing adequate screening questionnaires (3) examining the feasibility in acute psychiatric environment -pilot study; (4) getting organizational acceptancefeasibility study; (5) App construction; (6) Workshop with adolescents -what do the patients think; (7) evaluation -research study 1 & 2. Results: (1) We decided to create a smartphone application based on our previous work on interactive voice response. (2) Eleven validated screening questionnaires were chosen with regard to frequent comorbid states in child & adolescent psychiatry. (3) A pilot study was performed (n=16) indicating good acceptability. In the next step (4) we performed a feasibility study concluding that the method we planned adds value for our patients and no existing solutions were found on the market. The IT department gave their final approval for funding in May 2015. (5) The work resulted in a public procurement. (6) We performed a workshop indicating good feasibility. (7) Two studies will be performed, one in inpatients identifying comorbid conditions and the other to assess outpatient compliance and treatment outcome. Conclusions: A technically advanced and easy-to-use web based mobile phone application corresponding to the unit's needs was developed and two studies to evaluate its usefulness were planned.

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Bipolar Disorder and ADHD: Comorbidity and Diagnostic Distinctions

Cited by 67 publications

References 76 publications

Mortality in a cohort of 3.1 million children, adolescents and young adults

Mortality in a cohort of 3.1 million children, adolescents and young adults

Bipolar depression: the clinical characteristics and unmet needs of a complex disorder

Issues in Child and Adolescent Inpatient Assessment and Evaluation After Discharge: Protocol for App Development and a Randomized Controlled Trial (Preprint)

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